And, in fact, Cigna went out of its way to justify its refusal to cover such an experimental procedure. Unfortunately, they did cave, and agreed to pay for the risky surgery, which ultimately failed to keep poor Nataline alive.

"Cigna should have stuck to the contract. I bet they will have to pay a settlement now because of their change of mind."

That sounds about right:

Had they simply stuck to their guns in the first place, the outcome wouldn't have changed (Nataline wouldn't have survived), but they also would have a compelling defense. As it stands, by backing down in the name of PR, they face an uphill battle. My guess is that the case will be based on the simple question of timing: if Cigna had agreed to cover the surgery immediately, the argument will go, then Nataline would surely have survived. By "dithering" (i.e. actually following the correct process) Cigna reduced her chances of survival.

We'll never know, obviously, whether that would have been the case, but I think that Cigna erred in succumbing to public pressure. Had they stood their ground, such a lawsuit likely would have had little chance of success. As it stands, I think Cigna will be paying out quite a few more dollars.

If there's any silver lining, it's that perhaps other carriers will learn the correct lesson from this unfortunate event.

And, in fact, Cigna went out of its way to justify its refusal to cover such an experimental procedure. Unfortunately, they did cave, and agreed to pay for the risky surgery, which ultimately failed to keep poor Nataline alive.

"Cigna should have stuck to the contract. I bet they will have to pay a settlement now because of their change of mind."

That sounds about right:

Had they simply stuck to their guns in the first place, the outcome wouldn't have changed (Nataline wouldn't have survived), but they also would have a compelling defense. As it stands, by backing down in the name of PR, they face an uphill battle. My guess is that the case will be based on the simple question of timing: if Cigna had agreed to cover the surgery immediately, the argument will go, then Nataline would surely have survived. By "dithering" (i.e. actually following the correct process) Cigna reduced her chances of survival.

We'll never know, obviously, whether that would have been the case, but I think that Cigna erred in succumbing to public pressure. Had they stood their ground, such a lawsuit likely would have had little chance of success. As it stands, I think Cigna will be paying out quite a few more dollars.

If there's any silver lining, it's that perhaps other carriers will learn the correct lesson from this unfortunate event.